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General NPI Number Information
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NPI Number | 1639060312
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Entity Type | Organization
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Legal Business Name | FARMACIA AMIGA EN PUERTO REAL LLC
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Dates
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Enumeration Date | 07/11/2025
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | CARRETERA 308, KM. 5.1 BARRIO MIRADERO
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City | CABO ROJO
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State | PR
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Zip | 00623
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Country | US
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Telephone | 787-719-7828
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Fax | 787-709-4786
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Provider Business Mailing Address
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Address Line | PO BOX 506
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City | CABO ROJO
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State | PR
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Zip | 00623-0506
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Country | US
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Telephone | 787-719-7828
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Fax | 787-709-4786
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | CRYSTAL E RIVERA
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Credential | PHARM D
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Telephone | 787-400-1588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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